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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 49 41)0-54b 29 >D-546 ® 1.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS 099.OTHER(Specify): PANEL MANUFACTURER: Barco d90-55 MODEL#: 0 14100 490-56. LEAK SENSOR MANUFACTUREX- Gllbarco 490-51 MODEL#(S): 5950000011 490-58 DETECTION OF A LEAK INTO TH UDC TRIGGERS AUDIBLE AND VISUAL ALARMS IN a.YES ❑b.NO 490-59 UDC LEAK ALARM TRIGGERS AUTNN4ATIC PUMP SHUTDOWN ® a.YES ❑b.NO 490.60. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUT WN. IN a.YES ❑b.NO 490-6l UDC MONITORING STOPS THE FLOW O PRODUCT AT THE DISPENSER. ® a.YES ❑b.NO 490-62 2.UDC CONSTRUCTION IS ®1.SINGLE-WANED ❑2.DOUBLE-WALLED 490-63 IF DOUBLE WALLED: 490-64a UDC INTERSTITIAL SPACE IS MONITORED B I.LIQUID 0 2.PRESSURE 0 3.V UUM A LEAK WITHIN THE SECONDARY CONTAINME T OF THE UDC TRIGGERS AUDIBLE D VISUAL ALARMS ❑a.YES ❑b.NO 490-64b VII. ERIODIC SYSTEM TEST G I. ELD TESTING: THIS FACILITY HAS BEEN NOTIFI BY THE STATE WATER SOURCES CONTROL BOARD THAT ENHANCED 490-65, LEAK DETECTI N ELD MUST BE PERFORMED. PER DIC ELD IS PERFORME VERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 ®2.SECONDARY CONTAINMENT COMPONENTS ARE TESNED EVERY 36 MON S. 490.66 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490-67 VIII.RkORDKEVPING The following monitoring/maintenance records are kept for this facility: ®Alarm logs 4%-68a ❑Visual Inspection Records 490-68b ❑Tank' tegri testing results 490-68c ❑SIR testing results(and supporting documentation records). 490-68d ❑ Tank g ng results(and supporting documentation records). 490-68e ❑ATG Testing results(and supporting documentation records).490-68r ❑ Corrosio Protection 60-day logs 490-688 ®Equipment maintenance and calibration records. 490-68h IX.TRAIIaNkt ®Personnel with UST monitoring responsibilities are familiar with all of the fo owing docum is relevant to their job duties. 490-690- REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check II that apply) IN THIS UNDERGROUND STORAGE TANK MONITORING PLAN equired)490-696 ES OPERATING MANUALS FOR ELECTRONIC MONITORING E UIPMENT(Required)4 69c ❑ CALIFORNIA UNDERGROUND STORAGE TANKREGULAT NS 490-69d El CALIFORNIA UNDERGROUND STORAGE TANK LAW 490 e ❑ STATE WATER RESOURCES CONTROL BOARD (SWB) PUBLICATION: "HANDB OK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"490-69r ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMA IC TANK GAUGING SYSTEMS"4 LlOTHER(Specify):M69h.M6% This facility has a"Designated UST Operator"who has pass the California UST System Operator Exam a inistered by the International Code Council(ICC). The"Designated UST Operator"will train facility employees i the proper operation and maintenance of the UST stems annually,and within 30 days of hire.This training will include,but is not limited to,the following: ➢ Operation of the UST systems in a manner consistent th the facility's best management practices ➢ The facility employee's role with regard to the mom ing equipment as specified in this UST Monitoring Plan The facility employee's role with regard to spills an overfills as specified in the UST Response Plan ➢ Names of contact person(s)for emergencies and nitoring alarms.4N1-70 X. OMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate ho7 pages with additional information on specific monitoring procedures area ched to this plan.490-71 XI.PERSONNEL RESPONSIBILITIES The UST Owner/Operator is responsible for nsuring that: 1)the daily/routine UST monitoring activities and maintenance of UST leak detect, equipment covered by this plan occurs,2)all conditions that indic to a possible release are investigated,and 3)all monitoring records are maintained properly. The following person(s)are responsible f performing the monitoring and equipment maintenance' NAME j Eli 490-72 TITLE r 490-73 NAME James Abbott 490-74 TITLE Facility Technician 490-75 The Designated Operator shall pert rm a monthly visual inspection of the facility, provide a report to the owner/operator, and inform the owner/operator of any conditions that need follow-up act; . XII.OWNER/OPERATOR SIGNATURE CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. APPLICANT SIGNATURE 490-76 DATE: 490-77 7/30/2010 v r/ erator 0 e I't,Ow",01ma[or 3.A.h 6, R r—niauw of O,,ner APPLICANT NAME(print): APPLICANT TITLE: 490-79 Mike Eliason Cardbck Manager UPCF UST-D(12/2007)3/4